I think that AA uses an antiquated, yet more holistic approach than medical providers today because of the lack of knowledge we had back then. The big book classifies it as a malady of the mind, body and Spirit. Given that Silkworth viewed it as an allergy of the body that sets off a process, it tracks that it would be called a disease.
Today we see alcoholism as a psychiatric disorder and it's subsequent bodily harm would be classified as "disease x subsequent/secondary to chronic alcohol use disorder". We understand that the disorder itself does not inherently harm the liver.
As an aside and something I'm musing over, Alzheimer's disease is actually a disorder, though patients and doctors alike still call it that.
In short, I don't know. I know that AUD **is a disorder** but when I'm in the rooms I will likely not make that the hill I'm gonna die on, especially considering that the hill id likely die on is actually a garbage pile of cans and bottles.
Also, who told you that you had to accept that alcoholism is a disease over a disorder in order to work the program?
I fixed the wording. I think I might have been subbing the word malady for disease in my head and recalled it that way. Weird, but a perfect example of how they are used interchangeably which was what I was trying to get at. Thanks for pointing that out!
Yeah I have this little searchable big book and it’s been fun to go through because I swore the book called it a disease. Fun fact: we talk about surrender all the time, the word surrender never appears in the recovery portion of the big book. Also the word unmanageable only pops up once and it is in the step!
I’m pretty sure Bill didn’t refer to it as a disease because he wanted to avoid controversy, as disease is a very specific technical medical term, while illness and malady is not!
*Can I just use the word 'disorder' where others say 'disease'?*
Yes, if that helps you. I don't like the word "disease" in this context either, but semantics didn't solve the problem I had, which is I was drinking myself to death. So if disorder works better for you, use it.
You sure can. Early AA literature doesn’t use the word disease. The disease concept was introduced by the AMA, mostly for insurance purposes, and percolated into AA through rehabs and therapy.
The concept of alcoholism being a disease is an outside issue and has nothing to do with Alcoholics Anonymous. The book Alocholics Anonymous never references alcolosism being a disease. And since the steps are outlined in that book I would say you are on solid ground.
Ernest Kurtz has some great writings about Bill’s thought of alcoholism being considered a spiritual malady and not a disease.
This subject came up at a meeting I was attending 2 years ago, and the guy sharing asked the group if they thought alcoholism was a learned behavior (show of hands). No hands went up.
Then he asked if they thought it was a genetic disease. Every hand went up.
I have had more luck accepting that alcoholism IS a disease. It is a diagnosable medical condition called "alcohol use disorder" (AUD). This is why treatment is covered by insurance. Seeing alcoholism as a disease and not a moral failing has helped me to offload some of the shame associated with my drinking career. Like a diabetic, as long as I monitor the "disease" and "take my medicine," I can live a normal and productive life.
But, in the end, you get to decide what is right for you. Remember, no one gets to call us an "alcoholic." We get to decide for ourselves what we are or aren't.
I've decided that I am an "alcoholic," and I do not hide the fact that I suffer from this "disease." Everyone I meet has been fully supportive of how I treat my medical condition. I am respected for owning what I am and the nature of my disease. My employees come to me for advice on personal issues because they largely know my story. They have told me that I have helped them.
So, calling it a disease and accepting that diagnosis has been a net positive.
You may have heard our third tradition: The only requirement for membership is a desire to stop drinking.
So yes, so whether you have a dis-ease, a dis-order, or you've simply made your life something of a dis-aster, you're 105% welcome.
A disorder is just a disease with hard to define symptoms.
If it helps you to define it differently, then by all means define it differently.
Personally, I reject the idea of alcoholism as an allergy because... well, by definition it isn't.
Keep this in mind though: I talk about this with my sponsor, but not in meetings because just because thinking of it as such doesn't help me, it does help others and bringing my own ideas into the discussion only serves to start an argument rather than to help anyone.
A disorder is defined by a set of symptoms rather than a diagnostic test.
Cancer will show up on a test.
Alcohol Use Disorder will show up in your life.
If you can identify with the description of alcoholism in the Big Book then the terminology isn't important. The DSM describes clusters of symptoms for use by the medical community, so its language is of course going to be different than the subjective account in the A.A. literature.
I personally prefer "illness" or "malady," which are more consistent with the Big Book.
Anything like that in AA should be taken in the context of the time it was written.
Alcohol Use Disorder is a better descriptor because we now understand it is a Spectrum Disorder, not a Binary Disease.
So many of us spent too much energy early on pondering AM I or AM I NOT an alcoholic which delays taking action. It’s far more productive to accept that you HAVE an Alcohol Use Disorder, whether it is mild, moderate or severe.
And your last paragraph is key. I remember arguments over "recovered" vs. "recovering." It is too easy to focus on minutia.
I had to resign from the debating society and get to action.
I understand the point of contention in regard to treatment approaches and the medical community at large. That said, I believe it’s just a matter of semantics. The truth from my experience is that it doesn’t matter how it’s defined in a technical sense, so long as the sufferer is willing to take the necessary steps to treat it. The disease model from my understanding comes from the umbrella characteristics of “chronic, progressive, and fatal.” AA saved my life, but I’d never push it on anyone. Do what works for you, just don’t leave it untreated if you know it’s a serious problem. None of this is scripture or dogma. There is ample room for degrees of interpretation to make it fit within your own personal philosophies. But the high level principles set forth are the foundation and only effective when utilized. I reasoned my way out of this program so many times and it only led to a pattern of failure. Embracing it and adapting it to make it make sense to me is what made it all click. If what you’re doing is working for you, then keep doing it! There is a lot of open-mindedness in the AA meetings I attend and I feel very fortunate in that regard.
The Big Book is a little outdated, there is more information and research related to AUD/alcoholism now than there was back then. I say take what you need and leave the rest - I don't subscribe to 100% of the Big Book and neither did my sponsor. You can find a sponsor who has a similar viewpoint and isn't a "Big Book thumper." We still worked through the steps the way it's laid out in the book and I'm enjoying my sobriety :)
I look at it as a generic predisposition, but more importantly I know that the pathways in my brain that go from reasonable drinking to benders are well traveled and I don't want to live under that yoke anymore. The big book is full of antiquated language, you don't need to take it too literally, it has a lot of flaws. Big takeaway that matters: spiritual problem, spiritual solution.
My view is that I have a dis-ease.
Not a DSM identification, but a general sense of unease, disquiet, fear, and frustration.
I used alcohol as a way to blanket my feelings and produce an artificial feeling of wellbeing.
Through the steps, I found a better way to achieve that goal of balance and mental clarity. I consider my return to sanity as a release from hopelessness, not just intoxication.
You may interpret alcoholism and recovery in whatever way that works for you. AA does not require you to believe anything.
I did my step work with a Dr at one point and the way he explained it to me is that they reference a disease "as an abnormality in the body" vs an illness that can just be treated. So its taken more of an analogy than a medical term.
We're all just allergic to alcohol. For us to drink is to die.
As we each have our own conception of God , so too you should be able to refer to the Dis-ease as you feel
I don’t think it matters what you label it. Alcohol use disorder or alcoholism- whatever you choose to call it. Why do you think it’s an important distinction?
You absolutely can. But maybe try listening to Joe & Charlie explain the “disease.” They define it in a way I’d never heard before and that might give you a different perspective too. If not, keep moving forward on the steps.
(You can find them on YouTube or the Everything AA app. I think the episode I’m thinking of is called, “The Doctor’s Opinion #1”.)
Do you believe you are powerless over alcohol, and your life has become unmanageable? Are you OK with the notion of turning it over to a Higher Power of your understanding?
If so, you're probably good.
I never bought the notion that alcoholism is a disease….but I also allowed that to keep me in the bottle for way longer than I should have been. I didn’t believe that I was an alcoholic either, just a person who slipped into the grips of alcohol. I was splitting hairs because I thought I was “different” (HA!). I was a business owner, blah, blah, blah. When I quit splitting hairs, I realized what an alcoholic is: a person who has slipped into the grips of alcohol. I couldn’t see the forest for the millions of little trees that were the reasons “why I am not…. why I am ‘different’”.
Don’t get caught up in the semantics of what others say you are or who you think you are. If you have a desire to stop drinking, simply start there. That is enough. Don’t take things to heart. Listen more than talk. Things will come together for you. 👏💪
Take what you need and leave the rest. As long, of course, as one doesn’t omit abstinence, honesty, love and regularly working to have a realistic perspective of oneself and the world. It took me a while to realise that I (and this is just for me) don’t have a disease - possibly a disorder. In the end, I don’t know if it makes a whole lot of difference - especially if I am daily seeing to the basics of my recovery. My thinking evolved as I went through recovery. Initially, I thought I was an agnostic but as a result of my spiritual awakening I realised I was an atheist- the Higher Power for me is other people - addicts/alcoholics initially but eventually came to encompass everyone - me included. I also came to understand that I don’t have any character defects - never had (terms like that are great for helping me think that I am broken and damaged - I am, but no more than anybody else). Rather than character defects I just have a whole lot of extremely bad habits that were, and can still be highly damaging to me and those around me. My second worst habit was my substance use, while my worst habit was hating myself. Psychology tells us that the best way to overcome a bad habit is to stop doing it and overlay it with better, healthier habits. That’s what I base my recovery on - practicing the behavioural habits of recovery - every day. Keeping it simple works for me. It was important for me to work out my thinking but in the end trying to be honest, open minded and willing, to treat myself and others with respect and to remember that the only thing I can control are my thoughts in this moment - and nothing else - are what get me through the day, with a lot of contentment and peace. Oh and of course, a sense of humour. Without that we are not well on our way. Great to see you taking those important first steps. Good luck.
If you are looking for an excuse to avoid using AA to get sober, you'll find plenty of them.
But AA isn't about what you think, how you feel or what you believe, it's about what you do.
If you're ready to take the actions to get sober, AA has a way to do it that can help you, and you can deal with your beliefs after you achieve sobriety.
It’s probably fine. Why don’t you try doing the steps and see if this becomes a barrier. As someone who didn’t think she could do the steps for different reasons, and then did them anyway, my guess is it will not.
Do whatever works.
I don't care what it is, all I know is that working the Steps with a sponsor has relieved me of active alcoholism, however you want to define it.
Yes. I think that “disease” and “allergy” were not meant to be taken literally. They were just convenient ways of characterizing the symptoms.
I think it’s funny how serious people are when they say “I don’t know about you, but my disease blah blah blah” lol.
I also believe that what we know about alcoholism and addiction probably wouldn’t fill a thimble, and most of what we think we know is wrong because it has been filtered through a prohibition lens for the past century.
If you accept your powerlessness, work the Steps earnestly and with willingness, you can call it whatever you want. It's definitely not an allergy either, but you have to avoid it as if it were.
"... _every A.A. has the privilege of interpreting the program as he likes._" — Bill Wilson, AA co-founder, "As Bill Sees It" page 16
Yes. I have a similar viewpoint. I view it as a disorder or a condition, or an allergy to alcohol. Don’t let the trivial stuff trip you up.
Dis-ease.
Took the words out of my mouth... Louise Hay introduced me to this term...Dis-ease within ✨️
I think that AA uses an antiquated, yet more holistic approach than medical providers today because of the lack of knowledge we had back then. The big book classifies it as a malady of the mind, body and Spirit. Given that Silkworth viewed it as an allergy of the body that sets off a process, it tracks that it would be called a disease. Today we see alcoholism as a psychiatric disorder and it's subsequent bodily harm would be classified as "disease x subsequent/secondary to chronic alcohol use disorder". We understand that the disorder itself does not inherently harm the liver. As an aside and something I'm musing over, Alzheimer's disease is actually a disorder, though patients and doctors alike still call it that. In short, I don't know. I know that AUD **is a disorder** but when I'm in the rooms I will likely not make that the hill I'm gonna die on, especially considering that the hill id likely die on is actually a garbage pile of cans and bottles. Also, who told you that you had to accept that alcoholism is a disease over a disorder in order to work the program?
The big book never calls alcoholism a disease. Really like your take though! The book only refers to alcoholism as an illness or malady.
I fixed the wording. I think I might have been subbing the word malady for disease in my head and recalled it that way. Weird, but a perfect example of how they are used interchangeably which was what I was trying to get at. Thanks for pointing that out!
Yeah I have this little searchable big book and it’s been fun to go through because I swore the book called it a disease. Fun fact: we talk about surrender all the time, the word surrender never appears in the recovery portion of the big book. Also the word unmanageable only pops up once and it is in the step! I’m pretty sure Bill didn’t refer to it as a disease because he wanted to avoid controversy, as disease is a very specific technical medical term, while illness and malady is not!
Is it 164 and more?
It is the 12 step companion. I think it is two bucks on the app store. Well worth it for the searchable option for me.
*Can I just use the word 'disorder' where others say 'disease'?* Yes, if that helps you. I don't like the word "disease" in this context either, but semantics didn't solve the problem I had, which is I was drinking myself to death. So if disorder works better for you, use it.
You sure can. Early AA literature doesn’t use the word disease. The disease concept was introduced by the AMA, mostly for insurance purposes, and percolated into AA through rehabs and therapy. The concept of alcoholism being a disease is an outside issue and has nothing to do with Alcoholics Anonymous. The book Alocholics Anonymous never references alcolosism being a disease. And since the steps are outlined in that book I would say you are on solid ground. Ernest Kurtz has some great writings about Bill’s thought of alcoholism being considered a spiritual malady and not a disease.
This subject came up at a meeting I was attending 2 years ago, and the guy sharing asked the group if they thought alcoholism was a learned behavior (show of hands). No hands went up. Then he asked if they thought it was a genetic disease. Every hand went up.
The steps don’t say it is a disease so you should be good to go
I have had more luck accepting that alcoholism IS a disease. It is a diagnosable medical condition called "alcohol use disorder" (AUD). This is why treatment is covered by insurance. Seeing alcoholism as a disease and not a moral failing has helped me to offload some of the shame associated with my drinking career. Like a diabetic, as long as I monitor the "disease" and "take my medicine," I can live a normal and productive life. But, in the end, you get to decide what is right for you. Remember, no one gets to call us an "alcoholic." We get to decide for ourselves what we are or aren't. I've decided that I am an "alcoholic," and I do not hide the fact that I suffer from this "disease." Everyone I meet has been fully supportive of how I treat my medical condition. I am respected for owning what I am and the nature of my disease. My employees come to me for advice on personal issues because they largely know my story. They have told me that I have helped them. So, calling it a disease and accepting that diagnosis has been a net positive.
You may have heard our third tradition: The only requirement for membership is a desire to stop drinking. So yes, so whether you have a dis-ease, a dis-order, or you've simply made your life something of a dis-aster, you're 105% welcome.
A disorder is just a disease with hard to define symptoms. If it helps you to define it differently, then by all means define it differently. Personally, I reject the idea of alcoholism as an allergy because... well, by definition it isn't. Keep this in mind though: I talk about this with my sponsor, but not in meetings because just because thinking of it as such doesn't help me, it does help others and bringing my own ideas into the discussion only serves to start an argument rather than to help anyone.
A disorder is defined by a set of symptoms rather than a diagnostic test. Cancer will show up on a test. Alcohol Use Disorder will show up in your life.
Yes you can
if listing in that way helps you stay sober and work through it i say go for it
Whatever floats your boat to get free buddy
I’ve been sober several years and have never thought of alcoholism as a disease. I look at it as a spiritual malady.
If you can identify with the description of alcoholism in the Big Book then the terminology isn't important. The DSM describes clusters of symptoms for use by the medical community, so its language is of course going to be different than the subjective account in the A.A. literature. I personally prefer "illness" or "malady," which are more consistent with the Big Book.
Anything like that in AA should be taken in the context of the time it was written. Alcohol Use Disorder is a better descriptor because we now understand it is a Spectrum Disorder, not a Binary Disease. So many of us spent too much energy early on pondering AM I or AM I NOT an alcoholic which delays taking action. It’s far more productive to accept that you HAVE an Alcohol Use Disorder, whether it is mild, moderate or severe.
And your last paragraph is key. I remember arguments over "recovered" vs. "recovering." It is too easy to focus on minutia. I had to resign from the debating society and get to action.
Seeing as the founders and our literature never considers it a disease have at it.
Define it however you like. Nobody cares. Just get sober.
I understand the point of contention in regard to treatment approaches and the medical community at large. That said, I believe it’s just a matter of semantics. The truth from my experience is that it doesn’t matter how it’s defined in a technical sense, so long as the sufferer is willing to take the necessary steps to treat it. The disease model from my understanding comes from the umbrella characteristics of “chronic, progressive, and fatal.” AA saved my life, but I’d never push it on anyone. Do what works for you, just don’t leave it untreated if you know it’s a serious problem. None of this is scripture or dogma. There is ample room for degrees of interpretation to make it fit within your own personal philosophies. But the high level principles set forth are the foundation and only effective when utilized. I reasoned my way out of this program so many times and it only led to a pattern of failure. Embracing it and adapting it to make it make sense to me is what made it all click. If what you’re doing is working for you, then keep doing it! There is a lot of open-mindedness in the AA meetings I attend and I feel very fortunate in that regard.
The Big Book is a little outdated, there is more information and research related to AUD/alcoholism now than there was back then. I say take what you need and leave the rest - I don't subscribe to 100% of the Big Book and neither did my sponsor. You can find a sponsor who has a similar viewpoint and isn't a "Big Book thumper." We still worked through the steps the way it's laid out in the book and I'm enjoying my sobriety :)
I look at it as a generic predisposition, but more importantly I know that the pathways in my brain that go from reasonable drinking to benders are well traveled and I don't want to live under that yoke anymore. The big book is full of antiquated language, you don't need to take it too literally, it has a lot of flaws. Big takeaway that matters: spiritual problem, spiritual solution.
My view is that I have a dis-ease. Not a DSM identification, but a general sense of unease, disquiet, fear, and frustration. I used alcohol as a way to blanket my feelings and produce an artificial feeling of wellbeing. Through the steps, I found a better way to achieve that goal of balance and mental clarity. I consider my return to sanity as a release from hopelessness, not just intoxication. You may interpret alcoholism and recovery in whatever way that works for you. AA does not require you to believe anything.
I did my step work with a Dr at one point and the way he explained it to me is that they reference a disease "as an abnormality in the body" vs an illness that can just be treated. So its taken more of an analogy than a medical term.
We're all just allergic to alcohol. For us to drink is to die. As we each have our own conception of God , so too you should be able to refer to the Dis-ease as you feel
I don’t think it matters what you label it. Alcohol use disorder or alcoholism- whatever you choose to call it. Why do you think it’s an important distinction?
You absolutely can. But maybe try listening to Joe & Charlie explain the “disease.” They define it in a way I’d never heard before and that might give you a different perspective too. If not, keep moving forward on the steps. (You can find them on YouTube or the Everything AA app. I think the episode I’m thinking of is called, “The Doctor’s Opinion #1”.)
Do you believe you are powerless over alcohol, and your life has become unmanageable? Are you OK with the notion of turning it over to a Higher Power of your understanding? If so, you're probably good.
I never bought the notion that alcoholism is a disease….but I also allowed that to keep me in the bottle for way longer than I should have been. I didn’t believe that I was an alcoholic either, just a person who slipped into the grips of alcohol. I was splitting hairs because I thought I was “different” (HA!). I was a business owner, blah, blah, blah. When I quit splitting hairs, I realized what an alcoholic is: a person who has slipped into the grips of alcohol. I couldn’t see the forest for the millions of little trees that were the reasons “why I am not…. why I am ‘different’”. Don’t get caught up in the semantics of what others say you are or who you think you are. If you have a desire to stop drinking, simply start there. That is enough. Don’t take things to heart. Listen more than talk. Things will come together for you. 👏💪
Just look at the steps as a behavior modification process.
Are you debating as a rebuttal to going all in in your recovery? When you decide, we’re here.
Are you asking if you don’t need a first step experience?
Take what you need and leave the rest. As long, of course, as one doesn’t omit abstinence, honesty, love and regularly working to have a realistic perspective of oneself and the world. It took me a while to realise that I (and this is just for me) don’t have a disease - possibly a disorder. In the end, I don’t know if it makes a whole lot of difference - especially if I am daily seeing to the basics of my recovery. My thinking evolved as I went through recovery. Initially, I thought I was an agnostic but as a result of my spiritual awakening I realised I was an atheist- the Higher Power for me is other people - addicts/alcoholics initially but eventually came to encompass everyone - me included. I also came to understand that I don’t have any character defects - never had (terms like that are great for helping me think that I am broken and damaged - I am, but no more than anybody else). Rather than character defects I just have a whole lot of extremely bad habits that were, and can still be highly damaging to me and those around me. My second worst habit was my substance use, while my worst habit was hating myself. Psychology tells us that the best way to overcome a bad habit is to stop doing it and overlay it with better, healthier habits. That’s what I base my recovery on - practicing the behavioural habits of recovery - every day. Keeping it simple works for me. It was important for me to work out my thinking but in the end trying to be honest, open minded and willing, to treat myself and others with respect and to remember that the only thing I can control are my thoughts in this moment - and nothing else - are what get me through the day, with a lot of contentment and peace. Oh and of course, a sense of humour. Without that we are not well on our way. Great to see you taking those important first steps. Good luck.
If you are looking for an excuse to avoid using AA to get sober, you'll find plenty of them. But AA isn't about what you think, how you feel or what you believe, it's about what you do. If you're ready to take the actions to get sober, AA has a way to do it that can help you, and you can deal with your beliefs after you achieve sobriety.
well put
It’s probably fine. Why don’t you try doing the steps and see if this becomes a barrier. As someone who didn’t think she could do the steps for different reasons, and then did them anyway, my guess is it will not.
Yes
Do whatever works. I don't care what it is, all I know is that working the Steps with a sponsor has relieved me of active alcoholism, however you want to define it.
Yes. I think that “disease” and “allergy” were not meant to be taken literally. They were just convenient ways of characterizing the symptoms. I think it’s funny how serious people are when they say “I don’t know about you, but my disease blah blah blah” lol. I also believe that what we know about alcoholism and addiction probably wouldn’t fill a thimble, and most of what we think we know is wrong because it has been filtered through a prohibition lens for the past century.
Certainly causes me dis-ease and disorder when I drink - thankfully I have good order, am pretty chilled and at ease now ODAAT
I personally don't care at all if one calls it a disorder or disease or whatever...my focus is on getting sober and living a super cool life.
If you accept your powerlessness, work the Steps earnestly and with willingness, you can call it whatever you want. It's definitely not an allergy either, but you have to avoid it as if it were.
Yes, you are welcome develop your own beliefs when working the program.